Dr. Orr Limpisvasti, an Anaheim sports medicine specialist and orthopedic surgeon, treats baseball players from the Angels on down to Little Leaguers.

But since most professional players started out playing youth ball, he embarked on a study funded by Major League Baseball on injuries in young pitchers. The results will be published in The American Journal of Sports Medicine.

Here he discusses the research as well as recommendations for protecting young athletes.

Q: Why are young pitchers more susceptible to injuries?

A: They play more baseball than college or professional players. They’re much more prone to overuse and they’re still growing.

Q: Can you describe your study of young baseball players?

A: With the advent of the biomechanical lab we’ve been able to capture pitching motion and calculate how much stress is being felt on the various joints in the shoulder and elbow. We took some of the more common pitching errors and to see what happened if we measure a whole bunch of kids who pitch.

We studied 169 kids between 9 and 18. We put them into the motion analysis lab. We had them pitch. We looked at the ones that pitch correctly or incorrectly. Then we looked at how that correlated with stress in the upper extremity joints. What we found was particularly in the young kids between 9 and 13 the pitchers that were able to throw with better mechanics actually had lower stress on their joints.

Q: What’s an example of proper form for preventing injuries?

A: With the stride, when the front foot lands, if the position of the shoulders is still in a closed position. With the older kids or the better throwers, when the front foot hits, the shoulders haven’t rotated open yet.

Most things that you look at when you’re coaching pitching, it’s not in the arm itself. A lot of it is actually controlled by the trunk and torso. If everything is timed correctly the arm position follows. … Little League has pitching guidelines, how much to pitch and how many days off and what types of pitches to throw.

Q: What are you doing with the results?

A: This is a study that was funded by Major League Baseball. We’re probably going to discuss with them the best way to distribute this knowledge. (Proper form) is not the biggest recommendation. By far the biggest risk factor is overuse, even though our study was looking at one of the finer points.

Parents and coaches often overemphasize mechanics. Even a perfectly thrown pitch has an incredible amount of stress on the arm because it’s not what the arm is meant to do. The general recommendation now to prevent overuse is three or four months off any baseball activity, which never happens in Southern California.

Q: What types of injuries do you see among young players?

A: First thing is to really establish the diagnosis, which most of the time in young players is a growth plate injury. (The growth plates are the areas of growing tissue near the ends of long bones.)

They read the press and listen to ESPN and think they’re going to have the same injuries as their heroes. Being young and healthy they will heal pretty well if they allow the body to heal itself. It’s rest and time.

The hardest part is the psychological aspect. That’s the big hurdle when you tell a young player who plays 12 months out of the year that they have to step away from it. I often have parents that are in tears. They truly believe their 13-year-old is the next Nolan Ryan.

Courtney Perkes has covered the medical beat for the Register since 2005. She was queasy when she watched surgery for the first time (a knee replacement) especially when a drop of blood splattered in her notebook! She loves writing about public health issues as well as the courage and resilience of patients facing illness. Courtney strives to lead a healthy lifestyle that includes yoga and not microwaving plastic. She is a graduate of Northwestern University's Medill School of Journalism.

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